Preoperative androgen-deprivation therapy for clinical stage T3 prostate cancer

C. L. Amling, M. L. Blute, E. J. Bergstralh, J. M. Slezak, S. K. Martin, H. Zincke

Research output: Contribution to journalReview article

13 Scopus citations

Abstract

The widespread availability of luteinizing hormone-releasing hormone analogues has renewed interest in androgen-deprivation therapy (ADT) before radical prostatectomy. Neoadjuvant ADT in patients with clinically localized tumors has resulted in decreased margin-positive rates and increased rates of organ-confined disease. Unfortunately, the pathological effects of ADT in patients with locally advanced (cT3) prostate cancer have been less marked. This article reviews our experience with neoadjuvant hormonal therapy in patients with clinical stage T3 prostate cancer. In a case-control study of cT3 patients undergoing radical retropubic prostatectomy between 1985 and 1992, 72 patients receiving preoperative ADT were compared with a matched group of 144 untreated patients in terms of pathological outcome and long- term disease-free survival. A local downstaging effect in hormonally treated patients was suggested by lower rates of extracapsular extension, but only 31% had organ-confined disease. Hormonally treated patients showed no benefit in survival or disease progression compared with patients who did not receive this therapy. Although preoperative ADT may decrease the incidence of extracapsular extension in clinical stage T3 prostate cancer, our data suggest that it has no significant effect on survival or disease progression in patients with locally advanced disease.

Original languageEnglish (US)
Pages (from-to)222-229
Number of pages8
JournalSeminars in Urologic Oncology
Volume15
Issue number4
StatePublished - Dec 29 1997
Externally publishedYes

Keywords

  • Androgen deprivation therapy
  • Prostatectomy
  • Prostatic neoplasms

ASJC Scopus subject areas

  • Urology

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    Amling, C. L., Blute, M. L., Bergstralh, E. J., Slezak, J. M., Martin, S. K., & Zincke, H. (1997). Preoperative androgen-deprivation therapy for clinical stage T3 prostate cancer. Seminars in Urologic Oncology, 15(4), 222-229.